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Why many transgender people feel they have to change their bodies

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A common question about transgender people, recently cropping up in a top-voted thread on Reddit, is why they can't just get therapy to deal with their feelings and learn to accept the bodies they were born with.

But this question is a bit like asking why gay and lesbian people can't just learn to get over their feelings and date people of the opposite sex instead. Gender identity appears to be inherent, based on the experiences of trans people and the research on this very topic. Many trans people have felt since birth, or at least a very young age, that they were born in the wrong body — and for some, but not all, medical procedures are needed to help alleviate those feelings.

Gender identity appears to be inherent

The gender unicorn explains the difference between gender identity, gender expression and presentation, sex assigned at birth, and sexual and romantic attractions. Trans Student Educational Resources

The vast majority of Americans are cisgender, meaning they identify with the sex they were assigned at birth. Perhaps because of this — and because people who are trans have been visible in the mainstream media only relatively recently — there's an exposure gap for many Americans. For them, it can be difficult to understand how, for instance, a person born with a penis and raised as a man identifies as a woman.

Lily Carollo, a trans woman in Burbank, California, said she helps cisgender people expand their views on gender identity through a thought exercise that, if successful, conveys the feeling of being born in the wrong body that many trans people feel. She begins by asking people if a huge sum of money would get them to physically transition to the opposite gender. Most people say no, she said, because they'd rather continue presenting themselves as the gender they were born as and identify with. "If you go into why they're answering no, they'll usually say that it wouldn't feel right," Carollo told me earlier this year. "That's what you lock into. Take that sense and imagine if you had been born in the opposite body."

These feelings are something trans people appear to hold either at a very young age or from birth. "I always knew," Jordan Geddes, a trans man in Columbia, Maryland, said. "But I grew up and had the whole world telling me I'm wrong. At that point [as a child in the 1990s], there was no visibility whatsoever about trans issues. My parents just assumed I'm a very butch lesbian."

The empirical evidence backs this up. Researchers at Boston University School of Medicine conducted a review of the current scientific studies, and concluded that the available data suggests there's a biological link to a person's gender identity, indicating that trans people are essentially assigned genders at birth that don't match their inherent, biologically set identity. And a study from the TransYouth Project found that trans children as young as 5 years old respond to psychological gender-association tests, which evaluate how people view themselves within gender roles, as quickly and consistently as those who don't identify as trans.

This all comes with the caveat that not all trans people undergo surgeries or hormone treatments to change their bodies. Some trans people — perhaps those who aren't as privileged as Caitlyn Jenner — simply can't afford the costly medical procedures, which aren't always covered by health insurance. Other trans people simply don't want to go through the surgeries, perhaps because they're satisfied with their bodies despite their gender identity. It varies from person to person.

But the bottom line is that what might drive some people to want to change their bodies appears to be inherent. Trying to make someone disregard that base characteristic is a bigger demand for many trans people than going through some physical changes.

Watch: Life as a transgender woman